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Dry Mouth After Full Mouth Reconstruction

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I had crowns put on all my teeth, top and bottom. Ever since the procedure, I’ve had a hard time keeping my mouth closed all the way and I’ve got horrible dry mouth as a result. My dentist did what he called opening my bite so that you could see more of my smile. I was really looking forward to having a beautiful smile but this is miserable. Should I have him grind them down? I feel all the money I saved up for this has been wasted.

Shannon

Dear Shannon,

woman covering her mouth

Putting crowns on all your teeth is known as a full-mouth reconstruction. This procedure is extremely complicated and is usually reserved for some of the more serious dental cases, such as advanced TMJ Disorder. It’s unusual to use it for cosmetic reasons. The standard procedure for a smile makeover is to use porcelain veneers. Substituting crowns for this tells me he doesn’t have advanced training in cosmetic dentistry so he did crowns, which he felt confident in. The problem is placing one crown is much different from than crowning all the teeth, which would take advanced reconstructive training. It appears your dentist does not have that either.

It appears when he opened your bite, he caused what is known as lip incompetence. This means your mouth does not close while it is in repose. There is good news and bad news here. First, the good news. Your dentist messed up and he messed up badly enough that this case will need to be redone AND it should be redone at his expense. You will get a second chance for that smile you have always wanted.

Now for the bad news. Lip incompetence, which leads to the dry mouth you are experiencing, can destroy the health of your teeth. Because of that, you will need to get this repaired rather quickly. Dry mouth means you are not getting enough saliva in your mouth. Most people don’t realize this, but saliva is one of the main defenses our teeth have in fighting decay. Saliva is loaded with bacteria killing minerals. Without your saliva, your teeth will quickly start decaying.

I want you to get a second opinion from an expert in reconstructive dentistry. Look for someone with qualifications like you can read about in Dr. Marion’s bio. If what I is think is going on, he or she can fix this at your original dentist’s expense.

Unfortunately, because you have dental crowns, you will always need dental crowns.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

I’m Concerned About Her Full-Mouth Reconstruction

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I have been going to the same dentist for six years. In that time, I’ve had four dental crowns placed on front teeth that have the metal foundation. This has caused some ugly gray stains on my gums and the crowns keep chipping. She repairs them but charges me for every repair, which I am a bit sick of. So, I went to see another dentist Dr. P—- (name withheld) to get these done right. He told me I need a full mouth reconstruction because my bite is completely off. The temporary crowns look fine, but they hurt when I try to eat. I hope this changes with the permanent ones. My dentist feels it will. As far as the appearance, the one thing I am concerned about is the eye teeth. I would like them a little longer. Do you think it will be too late to fix that? Am I being too picky? I don’t want to upset my dentist because he is much better than the last dentist I went to see.

Asia

Dear Asia,

Dental Crown Being Placed on a tooth

I am very glad you wrote. Not only are you not being too picky, you are not being picky enough. The first thing I want you to do is call your new dentist and ask for the lab order to be placed on hold until you have temporary crowns that fit properly. Then make sure your dentist knows you will not go forward with this until the temporaries are right. You should have no trouble with eating or anything else. They should feel perfectly natural. Putting the permanent ones in will not change how they feel because they are modeled after the temporaries. If the temps hurt, the permanent ones will too.

Another concern I have is the dentist you are using. When I looked him up, there is no advanced training listed that qualifies him for this procedure. Doing a full-mouth reconstruction is one of the most advanced procedures around. I am honestly not certain he is qualified to do this. In fact, I am going to recommend you get a second opinion by someone who does have the advanced training necessary.

I can’t stress enough how important this is. If this isn’t done correctly, he can completely mess up your bite, leaving you with a lifetime of pain and TMJ Disorder. When you are looking for that second opinion dentist, look for someone who has training at either the Pankey Institute in Florida or the Las Vegas Institute for Advanced Dental Studies.

I am going to suggest you get the second opinion before letting your dentist do anything else.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

A Full Mouth Reconstruction for Teeth Whitening??

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I have an old dental crown that really needs to be replaced. They’re quite old. I have several porcelain veneers about the same age. These were all done by a dentist from another city where I used to live. My new dentist wants to replace all my teeth with dental crowns. This suggestion is because my teeth are not very white and he thinks this is the best way to make sure everything matches. This seems rather drastic to me. Can’t I replace them all with porcelain veneers instead of dental crowns? That way I don’t have to grind down my teeth that are healthy. Isn’t that a better solution?

Kathleen

Dear Kathleen,

woman covering her mouth

Yes, that would be a better solution. However, I have an even better one that will save you a significant amount of money. Unless you have a reason for wanting veneers on the teeth that don’t currently have them, such as wanting a complete smile makeover, then the simplest solution to your teeth not being white enough is to do teeth whitening. I’m absolutely appalled he is suggesting crowning all your teeth instead of whitening them.

Such a procedure is known as a full-mouth reconstruction. It is one of the most difficult and advanced procedures there is. In order to do it properly takes extensive post-doctoral training. Not only that, but if your dentist doesn’t do it correctly, it can completely throw off your bite leaving you with painful TMJ Disorder.

Here is my suggestion. If you just want to replace the old dental work. First, get your teeth whitening. Then, get the dental work replaced. You will only need one crown. Replace the porcelain veneers with more veneers. However, I am going to suggest you find a different dentist to do this. I don’t trust this one. You will want one who does beautiful cosmetic work. Check out their smile galleries to see what type of results they get.

If you want a full smile makeover, you would do the same as above, but you could add more porcelain veneers to the procedure, rather than just the ones you need to replace. Again, you will need a dentist better than the one you have.

I hope this helps.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

This Full-Mouth Reconstruction is a Disaster

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I need some help. My teeth were in bad shape. I’ve had six dental implants placed and the dentist is placing crowns on the remaining teeth. The implants are done and now he’s on the dental crowns. It doesn’t feel like the sides of my mouth are even. The teeth on one side hit, but not the other. My jaw hurts all the time. While it ached a little before the treatment happened, now it is constant. My dentist said he meets all the checkpoints and thinks I am just not used to having crowns in my mouth. How long should it take me to get used to this? What if I don’t?

Emma

Dear Emma,

woman holding her jaw in pain

Whenever you are crowning all the teeth, the way your dentist is, it is known as a full-mouth reconstruction. This is a very advanced procedure and very few dentists can do it well. I am not certain your dentist has the training necessary to do this correctly and it sounds like you are going to have a disaster on your hands. Your dentist said he met all the checkpoints. However, one of the basic checkpoints is that the teeth come together naturally and simultaneously. His comment that you are just not used to having dental crowns doesn’t give me any more confidence in him either. When dental crowns are done properly, you don’t notice them at all. There is no “getting used to them”.

The reason you are in so much pain is your teeth are not occluding properly. This is essential and will only lead to more severe problems if not repaired. So, where do you go from here?

My suggestion is you find a qualified dentist to look at your case. I suspect it will need to be redone. Look for a dentist who has done extensive training with one or more of the following post-doctoral training institutes:

  • The Pankey Institute
  • The Dawson Academy
  • The Las Vegas Institute for Advanced Dental Studies

Based on your description, I think the case will need to be re-done. Have the dentist check your dental implants as well. If you only need the crowns re-done and not the implants, ask for a refund on crowns only. If both need to be replaced, my suggestion, in that case, is instead of a refund you ask for him to pay to have the work replaced at the dentist of your choosing. This is because the cost of replacing implants is more than the original procedure— a result of needing bone grafting to replace the bone lost during the removal of the original implants.

This blog is brought to you by Dr. David Marion who tries to be the best dentist in Duluth, GA.

Full-Mouth Reconstruction Horror Story

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I had twenty-year-old veneers that needed to be replaced. My new dentist said what I really needed was a full-mouth reconstruction. I trusted him but am now having serious doubts about this whole thing. The temporaries never felt right. Ever. I complained about them multiple times and he kept telling me that they were fine and things would be different when the permanents were in. Well, it’s not. I’m in pain and can’t even keep my mouth closed normally. My mouth is so dry I’ve been sucking on popsicles and drinking water non-stop. I feel like a water balloon and am miserable. I went back to the dentist complaining but he says he met all the check points and I’m just not used to crowns yet. Please tell me what to do? What is a reasonable amount of time for me to get used to this?

Gina

Dear Gina,

woman smiling with dentist behind her

You are in serious trouble here. This dentist has messed up big time. First, I’m trying to figure out why the full-mouth reconstruction was necessary to begin with. You said your porcelain veneers were old and need to be replaced. Fine. Do you know what the solution to that is? Replacing them with new porcelain veneers. A full-mouth reconstruction is a major overtreatment and one he hasn’t done correctly.

Your Dentist Blew it

When dealing with this type of case, which involves putting dental crowns on every tooth, the temporaries are worn to make sure everything occludes well and your bite is comfortable. If your bite was comfortable before but painful now, he did something wrong. Combine that with the fact you can no longer close your mouth when it is in repose and it sounds like your dentist opened up your bite too much. This is serious.

I don’t care if he says he met all the checkpoints. He didn’t. One of the first things to check is whether or not the patient can close their mouth normally and comfortably. So, either he is a liar or he doesn’t know what the checkpoints are. Neither of those bode well for either of you.

Your case needs to be re-done from the beginning. Please, for the love of all that is good, don’t allow this dentist to re-do it. Get a refund and get a different dentist to re-do your case.

Finding a Reconstructive Detnist

The first thing I’d like you to do is click here to read Dr. Marion’s professional bio. This is the type of dentist you will need to fix this properly.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Full-Mouth Reconstruction Horror Story

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I had every tooth crowned because I am a tooth grinder. The results were terribly unattractive but I know I needed teeth and not nubs. I’m not sure they were placed properly because my jaw ended up slanted a bit and I’ve had jaw clicking ever since. Somehow I managed to grind those down too. My pain worsened so I went to someone who said he was a neuromuscular specialist. He had me in an orthotic for a few years and that ended up opening my bite too much. Now I am worse off than ever. I feel like after all of this “treatment” I have gone backward. Is there any way to actually fix this? If I get another treatment, is there a way to get a functional AND attractive smile, or does it have to be one or the other?

Kelly

Dear Kelly,

woman with a beautiful smile

You have been through so much. Both the dentists you went to were either in over their head or just plain incompetent. Most teeth grinding, also known as bruxism, happens at night while you are sleeping. It doesn’t sound to me like either dentist provided you with a night guard, which is specifically designed to protect your teeth from nighttime grinding. This is such a basic solution, I am floored it never happened.

The second dentist who called himself a neuromuscular specialist was being deceitful. There isn’t a recognized specialty in neuromuscular dentistry. I’ll try and give him the benefit of the doubt that he meant he had a lot of training in neuromuscular care, but based on how your treatment went I am having my doubts.

Full-Mouth Reconstructions are Advanced Procedures

Crowning every tooth is known as a full-mouth reconstruction. Though, every dentist is trained in doing a dental crown, crowning every tooth takes more specialized knowledge and training. This type of training in how the teeth occlude together can only be gain post-doctorally. You need a dentist who has invested in that type of training. I’d like you to take a look at Dr. Marion’s training credentials. You absolutely need a dentist who has invested in this type of reconstructive and TMJ Disorder training. Without that, things will not improve and could actually get worse.

You asked an interesting question about your bite being both functional and attractive. Absolutely it can, but you have to go to the right dentist. Most dentists, especially those who do a lot of crowns and other reconstructive work have a strictly engineering mindset. You want a dentist who is also appearance oriented.

How to get both Form and Function in your Full-Mouth Reconstruction

These procedures need to be done with temporaries first. Your dentist should make up provisionals and have you try them in. You need to have your jaw in a comfortable position, have no trouble speaking, and barely notice the crowns. Everything should feel like there are natural teeth there. You also want to make sure it is easy for your mouth to close when you are in your natural “rest” position. In addition, you need to love the way the temporaries look. Don’t let them tell you the permanent ones will look better or that they can change the appearance after they’re bonded. Those are not true. If you’re not pleased with the temporaries, the dentist needs to go back to the drawing board.

Once the permanent crowns arrive, the dentist needs to first put them on with a temporary try-in paste, so you can see and feel them in your mouth before they are bonded. If you’re still pleased and comfortable, you can have them bonded.

I hope this helps.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.